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Emergency Medicine - Career Guide

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Mohammad Zaher

on 20 May 2015

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Transcript of Emergency Medicine - Career Guide

Emergency Medicine
Why
Emergency Medicine?

The Local Path
The Scholar Path
Which Path To Choose?
A Career Planning Guide
Mohammad Zaher
Ex-Chief Resident - Saudi Program of Emergency Medicine
Executive - Saudi Society of Emergency Medicine - Resident Chapter
Thank You!
dr.maz@hotmail.com
"Emergency medicine is the medical specialty dedicated to the diagnosis and treatment of unforeseen illness or injury.

The practice of emergency medicine includes the initial evaluation, diagnosis, treatment, and disposition of any patient requiring expeditious medical, surgical, or psychiatric care.

Emergency medicine may be practiced in a hospital-based or freestanding emergency department (ED), in an urgent care clinic, in an emergency medical response vehicle or at a disaster site."
American College of Emergency Physicians
What is Emergency Medicine?
We Are The Masters of Dealing With Uncertainty
We Can Spot a "Sick" Patient A Mile Away
We Deal with Other Specialties' Nightmares
We ARE Other Specialties' Nightmares
We Don't have a Circadian Rhythm
We Forgot What "Routine" Means
We Are Extremely Compassionate, But Forgetful
We Know a Little Bit About Everything
We Are The Most Helpful Physicians to Our Families
We Don't Do it for Fame, Prestige, or Money
Easier Acceptance
Better Income
More Stability
Shorter Training Time
Chance to Be With Family
Experience With Own Population
More Hya6
Better Reputation
Better Ethics
Better Education?
Chance to Run Away
A More "Exotic" Experience
North American Board
Choose a Path, THEN STICK TO IT!
It's a Firm decision to make!!

If it works, it'll rock your world!

If it doesn't, you've basically wasted 2-3 years of your life.

You need to have a plan, even if it is a stupid one!

Do NOT apply for scholar and local together!
The Scholar Path
TAKE YOUR EXAMS!
TAKE YOUR EXAMS!
TAKE YOUR EXAMS!
The Scholar Path
First Step?
TAKE YOUR EXAMS!
TAKE YOUR EXAMS!
TAKE YOUR EXAMS!
USMLE Step 1, USMLE Step 2 CK, USMLE Step 2 CS, MCCEE
OMG TOO MANY LETTERS!
• The first test of your commitment

• Require a huge amount of effort, time, and money.

• Can make or break your application, here and outside.

• Your aim is NOT AT ALL to pass! You need to ACE the exams to have a chance outside!
USMLE Step 1
• The stuff you were not really interested to learn

• Totally outside the range of your clinical practice

• Needs a vacation/leave from work

• Needs AT LEAST 3-4 months of intense Dafra!

• Best done during medical school, preferably at a summer vacation.

• A Kaplan/Falcon Course is VERY helpful and strongly advised!
What Would I be Doing in 4 Years?
Clinical
Non-Clinical
Pediatric Emerg. Med.
Critical Care Medicine
Resuscitation Medicine
Toxicology
Disaster Medicine
Pre-Hospital Medicine
Trauma
Ultrasound
Hyperbaric Medicine
Environmental Medicine
Administrative Medicine
Faculty Development
Medical Education
Medical informatics
Public Health
Research

The Moment You Finish Your Residency You Are Ready To Lead A Shift!
But if You Want More..
International Medicine
Sports Medicine
Geriatric Emerg. Med
Flight Medicine
Cruise Ship Medicine
Wilderness Medicine
Injury Control
Forensic Medicine
Others
No, Really..
What is Emergency Medicine?
But.. Isn't it Stressful?
Most of the time it's not.
But At Rare Times..
Right On! I LOVE IT!
Where Do I Sign?
Not So Quickly!
You Need To Answer One Question First..
Local Or Scholar?
USMLE Step 2 CK and MCCEE
• Clinical Knowledge!

• Easier to prepare for while studying/working.

• Best taken during internship!

• Study Step 2 material for both exams, and take them together.
Step 2 CS
• Clinical Skills

• Needs about 1 month of reading.

• 1-week Courses available.

• Don't worry much about it.
When To Take The Exams
• Books (Kaplan notes, First Aid, Mothakkerat)

• Kaplan Step 1 and 2 Videos (Very helpful)

• Prep Courses (Kaplan, Falcon)

• Question Banks (USMLE world, Canada QBank)
7 Saudi Residents Accepted In EM Positions in The US.
All Accepted Through The Matching System.
2013-2014 Results

Only 2 Positions Offered For Saudis In Canada, None Accepted.
What To Study For the Exams
Sponsors For Scholars
Finding A Sponsor is Not Your Biggest Problem, It's the Acceptance Outside.
Burnout?
“A state of physical, emotional, and mental exhaustion caused by long term involvement in situations that are emotionally demanding.”
"Burnout was more prevalent in Emergency Medicine than other specialties"
Emergency Medicine Journal 2011;28:397e410.
"Despite exhibiting emotional exhaustion, the majority of respondents are satisfied with the career of Emergency Medicine."
Annals of Emergency Medicine 2009;54:106-113.
"The majority of respondents stated that Emergency Medicine has met or exceeded their career expectations."
Annals of Emergency Medicine 2008;51:714-722.

• Start applying outside:
• Individually, through your Hospital, the Attaché, or Matching

• Be Prepared to wait for 2-3 years before starting your residency

• If You can get a master's degree during that time, why not!

• Taking an elective MIGHT improve your chances
What After That?
To Sum it All Up..
The Local Path
• Saves you the Hassle
• Has Become A Hassle As Well.

• The EM Local Program is ranked as the 3rd best structured, organized, evidence based of Saudi Resident Training Programs.

• Four Years of Training to Be an EM Assistant Consultant.

• You can always do your fellowships outside, with much less effort than required for residency.
The Usual Time frame
2015 Application Statistics
The Local Path
Most important Step?
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
GET GOOD GRADES!
5000 total applicants for 1600 spots in all specialities / all regions
Modified matching system implemented for thr first time.
~400 applicants for 63 spots in EM / all regions
Applicants ranked according to score (50% SLE / 30% GPA / 20% CV)
EM applicants top score: 91/100. (Plastic Surgery: 88/100)
Top 50 in central region qualified for hospital inteviews (first round)
Saudi Commission for Health Specialties
The Local Path
The Central Region program is divided into 2 Tracks:
Track A (30 R1 spots / 2015)

King Abdullah Medical City
King Fahad Medical City
Prince Sultan M Medical City
Track B (17 R1 Spots / 2015)

King Faisal Specialist Hospital & RC
King Khalid University Hospital
Security Forces Hospital
King Saud Medical City
All the new applicants will have their separate rotations and activities.

For the time being, Track A is more established, and more competitive
Track B is actively growing, with less residents = More teaching.
Hospitals
Acceptance Score Included:
GPA, SLE, Interview, Recommendations, Knowledge Assessment.
Program Structure
- Emergency Medicine Rotations (Adult & Pediatric)
- Off-Rotations.

Anesthesia, Obstetrics, Orthopedics, Psychiatry, Research

CCU, General Surgery, ICU, Plastic Surgery

CCU, EMS, Hajj, Neurology, PICU

Electives, Education, Community Service
R1:

R2:

R3:

R4:
The Saudi License Exam
• A requirement for application to the Saudi Council.

• You can take it 3 times per year, 2 times per month.

• Right now, tests your luck and ability to memorize MCQs.

• 50% OF YOUR APPLICATION SCORE!

• Pass is 50, 65-75 is average, 75-80 is good, >80 is Excellent
The Selection Exam
Exam is being reformatted.
The Interview
• We're not used to them

• Can be unpredictable, but there are general principles

• People have different approaches

• The first one is always the hardest

• When you do more, it becomes like chewing gum
General Principles
• Be calm, Qoraan or Music/Propranorol are your friends.

• Be professionally dressed, whatever your style is!

• Be honest! But if you lie, Don't get caught!

• Be aware of what your CV says, they will ask you about it

• Be ready! Practice with friends, it works!
Common Interview Questions
Personality:
• Tell us about yourself
• Why did you choose ER?
• What is your Best / Worst Feature?
• What do you do in your free time?

Knowledge:
• (Direct medical question)
• What subjects in ER do you like?
• Tell us about an interesting case you saw during your work
• What ER Books do you know?
Common Interview Questions
Judgement:
• Where do you see yourself in 5/10 years?
• Scenario (Refused Referral / Abused Lady / Angry or Addict Colleague)


Bthara:
• Where did you apply?
• Did you apply for local/scholar?
• If you got accepted in both local/scholar, what would you do?
• If we didn't accept you, what will you do?
Ask for Advice
• Don't be shy, it's your future!

• Learn from others' mistakes

• Contact me
The Curriculum Vitae
Curriculum Vitae
GPA
Electives
Research
Courses
Conferences
Extracurricular Activities
•Your only non-exam qualifier to SCFHS
+ The first impression in hospital interviews
• Should not be less than 2 pages
• The contents should be "interesting"
• Start working on it now
• Important for some interviewers, but not all

• A High GPA Boosts Your Chances to Be Accepted

• If it's low, it's not the end of the world. You can easily divert attention from it by other elements in your CV
• Taking an elective where you want to be accepted is generally a nice idea, But if they don't like you, it's over.

• If you do take one, BE YOUR BEST!

• Electives say what your priorities are, so be careful

• Why not do an elective outside Saudi Arabia?
• Ignored by many applicants, Even though interviewers LOVE it!

• Don't be shy, Everything counts!
• Published or not
• Finished or not
• Still ongoing or canceled

• Literature reviews count!
• Advanced Life Support for Obstetrics (ALSO)

• Prehospital Trauma Life Support (PHTLS)

• Fundamental Critical Care Support (FCCS)

• Fundamental Disaster Management (FDM)
• Very important for your CV and your EM knowledge
• Book Early, and Book in KAMC if you can:
• Basic and Advanced Cardiac Life Support (BLS + ACLS)
• Advanced Trauma Life Support (ATLS)
• Pediatric Advanced / Advanced Pediatric Life Support (PALS / APLS)
• Neonatal Resuscitation (NRP)
Attend as many Emergency Medicine related conferences as you can.
• A nice addition to your CV
• Any volunteer work you did
• You'd be surprised what counts
SCFHS CV Score
Includes:
Research / Publications
Courses / Workshops
Conferences / Presentations
Extracurricular Activities
Awards / Appreciations
"Honesty, transperancy, and devotion will take you places."
Dr. Majid AlSalamah
SBEM Director
Full transcript